3.1 Quantitative results

One hundred respondents completed the survey between January and July 2018. We tracked eligibility and participation for 2 of the 6 months of recruitment in order to estimate a response rate. Of 73 patients seen by counsellors over that time, 46 met eligibility criteria and received study information (63%). Of those, 35 completed the survey (response rate = 76%). We excluded 2 surveys from our analysis; one for providing no information other than age, and the second for meeting an exclusion criteria (spontaneous abortion). We analyzed the remaining 98 surveys.

We present demographic characteristics in Table 1. The majority of the 98 respondents were white (n = 51, 52%), had completed at least some post-secondary education (n = 68, 69%), reported a household income above the poverty line ($30,000 CAD) (n = 53, 53%), and did not consider themselves to be religious (n = 65, 66%).

Table 1Demographics of respondents to survey at an abortion clinic in Vancouver, British Columbia (Canada) and their willingness to donate products of conception: January to July 2018 (N = 98)

The majority (n = 77, 79%) of respondents indicated they would be willing to donate their products of conception to research. The remaining respondents were not willing (n = 12, 12%), unsure (n = 6, 6%), or did not answer the question (n = 3, 3%). Half (n = 49, 54%,) had been invited to donate their products for separate basic science research either at the time of this or a prior abortion. Of those, 38 (78%) had donated their products. Of the 11 (22%) who had declined to actually donate, 3 (27%) stated that they would be willing to donate tissue to research. Willingness to donate tissue for research was similar between 49 respondents who were and 42 who were not actually asked to do so (n = 41, 80% vs n = 34,79%; p = 0.91). None of the demographics, including education, household income and religious affiliation, were significantly associated with willingness to donate tissue to research as we show in Table 1.Respondents’ knowledge surrounding research on products of conception was limited (Table 2). The majority were not aware of the possibility to donate products for research at the time of abortion (n = 73, 75%). The majority reported advantages to donating products to research (n = 52, 53%).

Table 2Summary of knowledge about tissue donation and comfort/feelings being asked to donate products of conception to research among all respondents in an abortion clinic in Vancouver, British Columbia (Canada): January to July 2018 (N = 98)

On a scale of very comfortable to very uncomfortable, the majority (n = 78, 79%) of respondents would be neutral to very comfortable being asked to donate their products. On a scale of very good to very bad, most respondents would feel no different (n = 45, 46%) or good to very good (n = 43, 44%) being asked to donate products. Among the 11 who declined to donate products (23% of 49 who were actually asked to donate), 8 (73%) stated they would feel uncomfortable being asked to donate products of conception.

Table 3 summarizes how respondents thought tissue donation would change how they felt about their abortion. We stratified based on whether they had ever been invited to participate in research involving actual donation of their products and, if so, stratified based on whether they donated. Of 38 respondents who had donated, 21 (55%) reported that donation either positively or very positively changed how they felt about their abortion. The remainder 17 (45%) reported that it did not change how they felt. Of the 11 who declined to donate, the majority stated that it would not change how they felt (n = 6, 55%) and 2 respondents (18%) stated that if they donated their tissue, it would positively change how they felt. Among respondents never invited to actually donate their tissue, the majority reported that donating their products to research would not change (n = 29, 69%) or would positively change (n = 10, 24%) how they felt about their abortion. Due to small numbers in these subgroups, power was insufficient to demonstrate statistically significant differences. The majority of respondents (n = 25, 60%) who had never been invited to donate their products of conception would have liked the opportunity to do so. Further, 72 (74%) of respondents supported a pregnancy tissue biobank to facilitate research in women's health.Table 3Perceived influence of tissue donation on how respondents felt about their abortion among those who reported on their participation in tissue donation at an abortion clinic in Vancouver, British Columbia (Canada): January to July 2018 (n = 91)a

Seven respondents did not answer whether they were asked to participate in tissue donation research.

Percentages were calculated based on the total number of respondents for the individual variable.

3.2 Content analysis of answers to open-ended questions

In the answers to open-ended questions regarding reasons why respondents would or would not be willing to donate tissue to research we identified the positive categories of “support for research” and specifically “support for women's health research,” “helping others,” “meaning beyond their individual experience” among 65 of 73 (89%) who were willing to donate their tissue and answered this question. Eight of 73 (11%) respondents indicated being willing to donate as they did not see a reason not to (“equivocal”). Categories among 7 of 7 (100%) respondents who were unwilling to donate tissue and who answered the question were “being uncomfortable” and “overwhelmed”. We identified the same categories as well as “contributing to education” in the answers to the question about advantages to donating tissue for research. The only disadvantage respondents reported was “being uncomfortable” being asked to donate tissue for research.

Our survey included open-ended questions regarding how donating or potentially donating tissue to research would change how they felt about their abortion. We stratified the analysis by whether respondents had ever been asked to actually donate their products of conception and by whether they had donated or declined. We identified similar positive and negative categories of responses as in the previous questions, with “meaning beyond the individual experience” being the most common category.